Gallstone disease and related risk factors in patients with Crohn disease - Analysis of 330 consecutive cases

Background: The reported prevalence of gallstone disease (GD), defined as c urrent gallstones or previous cholecystectomy for gallstones, in patients w ith Crohn disease ranges from 13% to 34%. The aim of this study was to char acterize the still undefined risk factors of this complication. Methods: A total of 330 consecutive patients with Crohn disease (189 males and 141 females aged 17-82 years, mean +/- SD age, 41 +/- 14 years) underwe nt liver ultrasonography. Results: A diagnosis of GD was made in 78 patients (24%), 54 with current g allstones and 24 who had undergone previous cholecystectomy. Its frequency was comparable in males and females (23% vs 25%), but was significantly ass ociated with age (P=.001), being 13%, 36%, and 51% in patients aged 44 year s and younger, 45 to 59 years, and 60 years and older, respectively (P=.001 ). Its prevalence significantly differed according to the site of the disea se at diagnosis (P=.02) and was unrelated to disease duration. Gallstone di sease was more frequent in patients who had undergone surgery (34% vs, 14%; P=.001) and was significantly associated with the number (P=.001) and site of bowel resections (P=.001), increasing from 28% in the patients who had undergone 1 resection to 53% in those having had 2 or more resections (P=.0 05) and being significantly higher in patients with a resection involving t he ileocecal region. Multivariate analysis showed that age; site of disease at diagnosis; and the presence, number, and site of bowel resections were significantly related to GD. Conclusions: In patients with Crohn disease, the frequency of GD is signifi cantly higher than that reported in the general population with comparable characteristics (z = 5.04, P < .001). Age; site of disease at diagnosis; an d the history, number, and site of bowel resections are independently assoc iated with GD.